This proposal constitutes the competitive renewal application of the University of Utah Unit for continued participation in the cooperative MFMU Network. The continued commitment of the University of Utah Unit to this national effort is backed by a four-year record of documented leadership and excellence in the following areas: (1) University/Community Synergy: The University of Utah Unit was the first to introduce the multi-site concept to the MFMU Network. In so doing, the University of Utah Unit combined the research capabilities and patient population of a Salt Lake City-based academic medical center (University of Utah Health Sciences Center) with the patient populations of three large community hospitals (LDS Hospital, Salt Lake City; McKay-Dee Hospital Center, Ogden; and Utah Valley Regional Medical Center, Provo). The University of Utah Unit is thus assured continued access to over 14,000 obstetrical patients per year and to the largest number of (insured) Caucasian women amongst participating MFMU Units. Similar university/community collaboration is now being progressively adopted by other participating MFMU Network Units. (2) Study Protocol Generation: The University of Utah Unit has contributed three new study protocols to the MFMU Network during the past four years, two of which have reached active status. This represents 50% (2 of 4) of all study protocols proposed and advanced to active status during the same time period. (3) Study Protocol Implementation: The University of Utah Unit has led in clinical recruitment to most MFMU Network study protocols and in the cleanliness of data submitted. This application documents the above record of leadership and excellence as well as the academic productivity of the University of Utah Unit during the past four years. Further, current information is provided with respect to the growing Utah patient base, the substantial ongoing investment in perinatal facilities and the increasing depth of the faculty roster. The University of Utah Unit remains committed to working cooperatively with NICHD MFMU Network staff and member units to identify worthy research areas, to developing and implementing protocols, to collecting and transmitting quality data and to analyzing and publishing the results of completed trials.